title: Predictors of posttraumatic stress in parents of children diagnosed with a disorder of sex development.
abstract: The aims of the current study were twofold: (1) to assess the prevalence/severity of posttraumatic stress symptoms (PTSS) as well as cognitive and emotional responses in parents whose children were diagnosed with a disorder of sex development (DSD); and (2) to assess factors which contributed to PTSS. We hypothesized that parents would show elevated levels of PTSS and that negative cognitive and/or emotional responses would be predictive. Participants were parents of children diagnosed with a DSD. Thirty-six mothers and 11 fathers completed a measure of posttraumatic stress and reported difficulties in the domains of cognition (e.g., confusion) and emotion (e.g., grief). Using multiple regression, we determined factors contributing to parental PTSS. Reported PTSS was high: 31 % of mothers and 18 % of fathers met the threshold for caseness for Posttraumatic Stress Disorder. Regression included: child sex, parent sex, child age at diagnosis, years since diagnosis, genital ambiguity, father occupation, cognitive confusion, and emotional distress. Only cognitive confusion contributed significantly to variance in PTSS. Parents of children with DSD may experience the diagnosis as traumatic, evidenced by high rates of PTSS in the current report. Assessment of reactions to their children's diagnoses revealed that cognitive confusion, and not emotional distress, predicted PTSS. In this case, direct cognitive interventions may be applicable. Though psychological support is widely recommended, no detailed intervention has been offered. Our findings suggest that we may directly apply models successful in other areas of pediatrics, such as pediatric oncology. Future studies may assess the usefulness of such an intervention.
authors.affiliation: Department of Paediatrics, Addenbrooke's Hospital, Box 116, Level 8, Hills Road, Cambridge, CB2 0QQ, UK, vp265@medschl.cam.ac.uk.
authors.forename: Vickie
authors.initials: V
authors.lastname: Pasterski
authors.forename: Kiki
authors.initials: K
authors.lastname: Mastroyannopoulou
authors.forename: Deborah
authors.initials: D
authors.lastname: Wright
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Zucker
authors.forename: Ieuan A
authors.initials: IA
authors.lastname: Hughes
mesh_terms: D002648:Child; D002675:Child, Preschool; D003071:Cognition; D012734:Disorders of Sex Development / Q000175:diagnosis* / Q000235:genetics / Q000523:psychology; D004644:Emotions; D005260:Female; D005835:Genitalia / Q000002:abnormalities*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010290:Parents / Q000523:psychology*; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D006113:United Kingdom / Q000453:epidemiology